Lifetime burden of mood swings and activation of brain norepinephrine turnover in patients with treatment-refractory depressive illness.

Background: We tested if duration and intensity of episodes in treatment-resistant affectively ill patients were related to cerebrospinal fluid (CSF) concentrations of monoamine metabolites.

Method: In retrospective life charts were recorded every previous episode of 37 patients with severe treatment-refractory affective disorders. 'Accumulated burden of mood swings' (ABMS, sum of each episode length x episode depth) was used to estimate the accumulated illness burden.

Preoperative skin testing of materials used in surgical procedures.

Postoperative skin complications increase health care costs and cause patient suffering. In the OR, patients are exposed to materials with adhesive substances that have the potential to cause allergic or toxic effects on the skin. Intraoperatively and postoperatively, these reactions can result in skin complications.

Family intervention in schizophrenia--impact on family burden and attitude.

Background: This study focuses on the effect of psycho-educative family therapy on the self-assessed burden in families in which one member has suffered from relapse of schizophrenia or a schizoaffective syndrome. The impact on the family's self-assessed attitude towards continuing to take care of the patient was also evaluated. Burden and attitude were assessed continuously during a period that contained no further relapse episodes.

Components of the metabolic syndrome-risk factors for the development of benign prostatic hyperplasia.

The purpose of the present study was to perform a BPH risk factor analysis in men, relating the prostate gland volume to components of the metabolic syndrome and to identify clues to the etiology of BPH. Our material comprised a consecutive series of 158 patients with lower urinary tract symptoms with or without manifestations of the metabolic syndrome. In this group, the measured volume of the prostate was related consecutively to potential risk factors.

Calculated fast-growing benign prostatic hyperplasia--a risk factor for developing clinical prostate cancer.

Objective: Whether there is an association between the development of benign prostatic hyperplasia (BPH) and clinical prostate cancer is controversial. The present report tests the hypothesis of an association between BPH growth and the development of clinical prostate cancer by examining stage, grade and PSA-level in men with recently discovered clinical prostate cancer with slow or fast-growing BPH. If the hypothesis is true, men with fast-growing BPH would have a more advanced clinical prostate cancer.

HLA-DQ genotypes in classic type 1 diabetes and in latent autoimmune diabetes of the adult.

In 1993-1996, islet autoantibodies, C-peptide, and HLA-DQ genotypes were evaluated in 345 insulin-treated diabetic patients of all ages from the Skaraborg Diabetes Registry 5-6 years after their diagnosis and in 216 control subjects from the Skaraborg County, Sweden, population. The aims of this study were to clarify the importance of age at diagnosis of diabetes for HLA-DQ associations in patients with classic type 1 diabetes and whether patients considered to have latent autoimmune diabetes of the adult differed in their human leukocyte antigen (HLA) associations. An abnormally low fasting C-peptide value was used as the definition of type 1 diabetes, found in 182 of 345 (53%) patients.

Breast cancer patients' satisfaction with a spontaneous system of check-up visits to a specialist nurse.

Aim: To describe breast cancer patients' satisfaction with a spontaneous system of check-up visits to a specialist nurse.

Background: There is little evidence that routine follow-up visits after breast cancer surgery influence survival or patient satisfaction. Consequently, there is a need to evaluate alternative follow-up programmes.

Patterns of sensitisation in the course of affective illness. A life-charting study of treatment-refractory depressed patients.

Background: A 'sensitisation' process over time has been suggested by Post and collaborators--the affective illness course shows a tendency towards more frequent, deeper, and less stress-related episodes over time. The main aim of the present study was to test the sensitisation hypothesis using a Swedish Life Charting program.

Methods: Thirty patients with treatment-refractory affective disorder, of whom four had bipolar I disorder, were first interviewed using a semistructural interview manual covering episodes, treatment and stress.

Satisfaction with routine follow-up visits to the physician--the needs of patients with breast cancer.

Follow-up visits after surgery for breast cancer constitute a large proportion of the outpatient consultations at surgical and oncological clinics. The reasons for the follow-ups include early detection of relapse, patients' well-being, and data collection for quality assurance and scientific studies. The aim of this study was to describe the needs of the patient with breast cancer and satisfaction with routine follow-up visits to the physician.

Hyperinsulinaemia as a risk factor for developing benign prostatic hyperplasia.

Objective: To determine the validity coefficient of the total prostate gland volume as an expression of the transition zone (TZ) volume. To test the hypothesis of hyperinsulinaemia as a causal factor for the development of benign prostatic hyperplasia (BPH).

Patients And Methods: Three hundred and seven consecutive patients with lower urinary tract symptoms were studied.

Clinical, anthropometric, metabolic and insulin profile of men with fast annual growth rates of benign prostatic hyperplasia.

The purpose of this study was to test the hypothesis of a causal relationship between high insulin levels and the development of benign prostatic hyperplasia (BPH) and to determine the clinical, anthropometric, metabolic and insulin profile in men with fast-growing BPH compared with men with slow-growing BPH. The present study was designed as a risk factor analysis of BPH in which the estimated annual BPH growth rate was related to components of the metabolic syndrome. Two hundred and fifty patients referred to the Urological Section, Department of Surgery, Central Hospital, Varberg, Sweden, with lower urinary tract symptoms with or without manifestations of the metabolic syndrome were consecutively included.

Spectral analysis of heart rate variability during desflurane and isoflurane anaesthesia in patients undergoing arthroscopy.

Background: We studied the effect of desflurane (DES) and isoflurane (ISO) on heart rate variability (HRV) using power spectral analysis (PSA) of RR-interval in 30 patients undergoing arthroscopy, prior to induction, during anaesthesia and up to 3 h of recovery. PSA can distinguish low-frequency (LF) component and respiratory sinus arrhythmia (RSA) that are known to reflect predominantly sympathetic and parasympathetic activity, respectively.

Methods: After premedication with diclofenac and midazolam the anaesthesia was induced with propofol and maintained during spontaneous ventilation with either DES or ISO added to a mixture of nitrous oxide and oxygen.

Does transurethral resection of a clinically benign prostate gland increase the risk of developing clinical prostate cancer? A 10-year follow-up study.

Background: Theoretical considerations have raised the suspicion that transurethral resection of the prostate (TURP) may increase the risk of developing prostate cancer in clinically benign prostate glands. Previous studies have not shown an increased risk among men who had undergone TURP for benign prostatic hyperplasia compared with the risk in age-matched control subjects. However, in all of these studies, all men with stage T1 prostate cancer in the TURP-group were excluded, possibly creating a bias, because no similar exclusion could be made for the controls.

Adoption of a demographic database for family studies of hereditary palmoplantar keratoderma type Gamborg Nielsen.

In the northernmost county of Sweden (Norrbotten) two different clinical and genetic types of hereditary palmoplantar keratoderma have been reported: a common autosomal dominant form, corresponding to the descriptions performed by Unna and Thost, and an obviously autosomal recessive form, which clinically differed from other diffuse palmoplantar keratodermas, named the Gamborg Nielsen type. For further family studies and to support its probably recessive inheritance a demographic mapping of four families with this rare keratinization disorder was performed. It could be shown that these families belonged to the same family at different levels of generations; however, a common ancestor, who connected these families was not found.

The dominant form of hereditary palmoplantar keratoderma in the northernmost county of Sweden (Norrbotten).

The frequency of autosomal dominant inherited palmoplantar keratoderma (HPPK) in the northernmost county of Sweden (Norrbotten) is 0.55%. Histopathological examination of 91 biopsies from patients with the dominant form of HPPK revealed no case of epidermolytic PPK.

Dermatophytes and keratin in patients with hereditary palmoplantar keratoderma. A mycological study.

Fourteen patients with hereditary palmoplantar keratoderma of the Unna Thost variety were included in the study. Dermatophytosis was found in 7 of the 14 patients. Six were affected with T.

Norfloxacin as prophylaxis against urethral strictures following transurethral resection of the prostate: an open, prospective, randomized study.

An open, prospective, randomized study was performed to investigate the effect of norfloxacin prophylaxis on stricture formation and operative outcome after transurethral resection of the prostate. After resection, the 359 patients studied were randomly divided into 2 groups: 1) those given norfloxacin as prophylaxis for 15 days following removal of the catheter (norfloxacin group) and 2) those given no antimicrobial prophylaxis during the same period (control group). Of the patients 94 were excluded.

The correlation of symptoms, occult blood tests, and neoplasms in patients referred for double-contrast barium enema.

One hundred and forty-nine patients (86 women) with a mean age of 64 years (52-74 years), referred for double-contrast barium enema (DCE), were invited to have fecal occult blood test and rectosigmoidoscopy (60 cm) (RSS) before the DCE. Carbon dioxide was used for inflation at RSS to enable the two examinations to be done at the same time. Eight adenomas < 1.

The anatomic range of examination by fibreoptic rectosigmoidoscopy (60 centimetres).

The purpose of the study was to investigate the anatomic location of the flexible rectosigmoidoscope (60 cm) when introduced as far as technically possible. One hundred and forty-nine consecutive patients referred for double-contrast enema (DCE) were examined with rectosigmoidoscopy before the radiologic examination, and CO2 was used for insufflation. A plain abdominal film was taken to locate the tip of the instrument when 60 cm or as much as possible of the instrument had been introduced.

Partial Achilles tendon tears.

Persistent pain in the Achilles tendon is often caused by partial ruptures leading to a hypoxic state in the tissues, insufficient healing, and a remaining, immature, and painful scar. The rupture is caused by overuse and conservatively treated with orthotic devices to reduce tendon load and physiotherapy to correct training errors and strength the muscle-tendon unit. Significant partial ruptures seem to respond poorly to conservative measures and do not improve with time.

Suprapubic catheter following transurethral resection of the prostate: a way to decrease the number of urethral strictures and improve the outcome of operations.

A prospective, randomized study was done to investigate the role of transurethral catheters in stricture formation after transurethral resection of the prostate. The operative outcome after using transurethral catheters made of 2 different materials compared with suprapubic catheters was also investigated. We studied 344 patients who underwent transurethral resection of the prostate.

Treatment of nummular psoriasis with a clobetasol propionate stick.

Twenty-two consecutive patients with nummular psoriasis were treated with a 0.05% clobetasol propionate stick on the right side of the body and with 0.05% clobetasol propionate ointment (Dermovate, Glaxo) on the left according to an intermittent application schedule.

Topical metronidazole gel. Use in acne vulgaris.

Two percent metronidazole and 5% benzoyl peroxide cream was evaluated in four clinical trials. It could be shown that this test cream was significantly better than 5% benzoyl peroxide jelly alone, and significantly better than a placebo cream. It was also shown that 2% metronidazole and 5% benzoyl peroxide cream was equal to systemic oxytetracycline therapy.

Urethral strictures following transurethral resection of the prostate. The role of the catheter.

Urethral stricture is the most common late complication of transurethral prostatectomy (TURP). The cause is unknown. A prospective, randomised study was undertaken to investigate the role of the transurethral catheter in stricture formation.